Donor <i>IL-10</i> and <i>FOXP3</i> single-nucleotide polymorphisms associated with post-transplantation outcomes

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers a potential cure for hematologic malignancies, but post-transplant complications, particularly graft-<i>versus</i>-host disease (GVHD), remain major challenges. Regulatory T cells and interleukin-10 (<i>IL-10</i>) play key roles in immune regulation. This retrospective study investigated the impact of donor <i>FOXP3</i>-3279 (rs3761548) and <i>IL-10</i>-819 (rs1800871) single-nucleotide polymorphisms (SNPs) on clinical outcomes in 92 allo-HSCT recipients, with emphasis on umbilical cord blood transplantation (UCBT). Among UCBT recipients, non-C/C <i>FOXP3</i> and non-T/T <i>IL-10</i> donor genotypes were associated with significantly worse progression-free and overall survival, as well as a higher incidence of chronic GVHD. Multivariable analyses confirmed the prognostic impact of these SNPs. These findings suggest that donor-derived SNPs in key immune regulatory genes may influence post-transplant immune reconstitution. <i>FOXP3</i> and <i>IL-10</i> genotyping could serve as useful biomarkers to guide donor selection and risk stratification in UCBT settings, potentially improving transplantation outcomes.